Posters

Postoperative steroid regimes for reducing cystoid macular oedema rates in an ethnically diverse population

Poster Details

First Author: M.Gillam UK

Co Author(s):    C. Cunningham                    

Abstract Details

Purpose:

Whilst undertaking cataract clinics in Harrow, London, UK, it was noted that a significant minority of post-operative patients were presenting with cystoid macular oedema (CMO) with or without anterior uveitis as a complication. This reduced space in clinics for new patients as such patients require further follow up. All patients were given post-operative dexamethasone but with varying frequency and duration. We implemented a new steroid regime with longer periods of high frequency dosing and wanted to review the effect of this on CMO rates.

Setting:

This study was undertaken within cataract clinics in a Moorfields Eye Hospital satellite clinic in Harrow, London, UK. An urban area in North West London where 40% of the population identify themselves as Caucasian, 46% Asian and 9% Afro-Caribbean.

Methods:

429 patients operated on under the care of one consultant surgeon between March and August 2016 were included. CMO was diagnosed on the basis of macula OCT scans which were requested by the reviewing clinician if CMO was suspected or vision had not improved as expected post-surgery. Records were reviewed for ocular and systemic co-morbidities, surgical complications as well as post-operative medications prescribed at the time of surgery. Dexamethasone prescriptions were evaluated for the frequency and duration of drops prescribed and whether the new modified regime was used. Only patients undergoing isolated phacoemulsification and intraocular lens implant were included.

Results:

140 patients underwent OCT scanning. 16 patients had CMO detected on these scans (3.6% of total), notably higher than the generally reported rate in the UK. The majority of these patients did not appear to have pre-operative risk factors for CMO development. All surgeries with post op CMO were uncomplicated. Only 1 patient developed CMO whilst using the drop regime designed for this population, others were using hospital standard post-operative drop regimes.

Conclusions:

Our study provides information on rates of CMO in ethnically diverse populations which may be significantly higher than those in the general UK population as documented in the Royal College of Ophthalmologists Cataract Guidelines. We propose that giving patients from this population higher frequency post-operative steroid for a longer period of time may reduce rates of post-operative CMO and reduce patient morbidity as well as the burden of additional clinic follow up requirements.

Financial Disclosure:

None